Brief cognitive tests as a decision-making tool in primary care. A population and validation study

Neurologia Pub Date : 2024-11-01 DOI:10.1016/j.nrleng.2022.08.001

M. Tainta , A. Iriondo , M. Ecay-Torres , A. Estanga , M. de Arriba , M. Barandiaran , M. Clerigue , M. Garcia-Sebastian , J. Villanua , A. Izagirre , J. Saldias , A. Aramburu , J. Taboada , J. Múgica , A. Barandiaran , A. Arrospide , J. Mar , P. Martinez-Lage

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Abstract

Introduction and objectives

Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program.

Material and methods

In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample.

Results

260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26.

Conclusion

BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC.

查看原文本刊更多论文

将简短认知测试作为初级保健的决策工具。人口与验证研究。

简介和目的：简短认知测试（BCT）用于初级保健（PC）中认知障碍（CI）的检测。然而，有关其在社区环境中的诊断效用（DU）的数据仍然很少。这项研究评估了 Fototest、T@M、AD8 问卷和 MMSE 在人群中的诊断效用。它提供了在 CI 早期检测项目中验证的新的临界点（CoP）：在人群和验证样本中，评估分两个阶段进行：第一阶段是筛查和实施 BCT；第二阶段是临床诊断，对 BCT 的结果进行盲测，并采用现行的 NIA-AA 标准。用 ROC 曲线下面积（aROC）评估了人群样本中 BCT 的 DU 值。尤登指数和特异性最好且能确保灵敏度达到 80% 的 CoP 被用来决定最合适的 CoP。在验证样本中计算了这些CoP的灵敏度、特异性和预测值。结果：260名参与者（23.1%，含CI）来自人群样本，177名参与者（42.4%，含CI）来自验证样本。在群体水平上，Fototest 的 UD 最佳（aROC 0.851），而在 Fototest 和 AD8 的组合下（aROC 0.875），UD 更佳。建议的 CoP 为 AD8 ≥ 1、Fototest ≤ 35、T@M ≤ 40 和 MMSE ≤ 26：BCT有助于检测 PC 中的 CI。这项工作支持使用要求更高的 PoC。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologia

自引率

0.00%

发文量

审稿时长

53 weeks